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SUBMISSION TO THE PARLIAMENT OF VICTORIA FAMILY AND COMMUNITY DEVELOPMENT COMMITTEE:
INQUIRY INTO PERINATAL SERVICES
Introduction
According to UNICEF (2010), the first six years of a child’s life are fundamentally important, they are
the foundation that shapes children’s future health, happiness, growth and development, and
facilitate a child’s successful transition to school, life‐long education and employment outcomes, and
long‐term well‐being.
The first 1,000 days of life ‐ the time spanning roughly between conception and a child’s second
birthday ‐ is a unique period of opportunity when the foundations of optimum health, growth, and
neurodevelopment across the lifespan are established (Walker et al, 2007).
There are a number of issues relating to the health, care, and wellbeing of mothers and babies
residing in the Corangamite Shire region during the perinatal period that are negatively influencing
these foundations, with potential long term detrimental effects (See Figure 1):
Figure 1: Source https://www2.health.vic.gov.au/about/publications/data/barwon‐south‐western‐
region‐2015
Service sector challenges in the Corangamite Shire
Service Co‐ordination
Inadequate sector‐based service co‐ordination is a pressing issue in Corangamite Shire which
impacts on engagement, support and outcomes for families. While co‐ordination tends to be less
problematic within agencies and organizations, there is no sector‐based service co‐ordination
process in place, which reportedly causes delays and disengagement from services.
Case Planning
As a consequence of sector‐based service co‐ordination deficits, case planning is often
compromised when more than two services are involved.
Referral Protocols
There are inconsistent referral protocols between perinatal services agencies, often
compromising the referral process and engagement of families into these services.
Referral Tracking
There is little or no referral tracking across the sector, and while individual services may
follow up on specific clients, processes and standards are often compromised as clients
move between agencies.
Delays to Intervention
Referrals to and from Child Protection (CP) Services in the Corangamite Shire, including
incomplete CP assessments and delays to CP interventions, result in issues relating to the
health, care, and wellbeing of mothers and babies residing in the Corangamite Shire region.
Inadequate access to services
Access to preinatal services is a significant issue for families residing in Corangamire Shire: many
perinatal service providers from the north (Ballarat), West (Warrnambool) and East (Colac/Geelong),
do not service either all or part of the Corangamite Shire.This ‘black hole’ in service delivery imposes
limitations as many families cannot/do not travel to access these services.
Increasing health and wellbeing complexity is a characteristic feature of families in the perinatal
period residing in the Corangamite Shire region, but availability of services to address these issues in
the region is inadequate. For example, Corangamite Shire has no locally based support services to
target the prevention, identification, and treatment of Family Violence, remarkable considering that
according to the Crime Statistics Agency (2016), the percentage change (increase) in FV Incidents
was 47.1% in Corangamite Shire in the 12 month period between 2015 and 2016.
Family violence among women and children is known to be one of the main causes of physical and
mental illness amongst women of childbearing age (Mouzos & Makkai 2004). Family violence has a
significant impact on the way a woman raises their child, ultimately affecting the development of
that child. Smith (2005) states that “many children exposed to family violence can experience
behavioural, emotional, developmental and psychobiological problems and difficulties with social
competence in the longer term”.
The literature review shows that screening for family violence “remains a controversial area, but
governments especially in high and middle income countries continue to implement screening policy
in health care settings, without addressing the key barriers reported by primary care professionals,
especially workloads, ongoing training and lack of effective multi‐agency collaboration. Without
addressing such barriers, there is doubt about the sustainability or effectiveness of screening”
(Stayton, 2005).
Summary
Rural and regional communities (usually) exhibit higher rates of disadvantage than their urban counterparts (https://www2.health.vic.gov.au/about/publications/data) which is a pivotal issue, not just for agencies and services, but importantly, for the people who constitute the communities they service. There are a number of issues relating to the health, care, and wellbeing of mothers and babies
residing in the Corangamite Shire region during the perinatal period that are negatively influencing
the foundations for optimum health, growth, and neurodevelopment across the lifespan with
potential long term detrimental effects.
Federal, State and Victorian Government can reduce the impact of these issues through:
1. The availability, quality and safety of health services delivering services to women and their
babies during the perinatal period.
2. Preventing any loss of commonwealth funding (in particular, the National Perinatal
Depression Initiative and Prevention of Family Violence Initiatives).
3. The adequacy of the number, location, distribution, quality and safety of health services
capable of dealing with high‐risk and premature births in Victoria.
4. The quality, safety and effectiveness of current methods to reduce the incidence of maternal
and infant mortality and premature births.
5. Access to and provision of an appropriately qualified workforce, including midwives,
paediatricians, obstetricians, general practitioners, anaesthetists, maternal and child health
nurses, mental health practitioners and lactation consultants across Victoria.
6. Addressing the disparity in outcomes between rural and regional and metropolitan
locations.
7. Identification of best practice.
References
Crime Statistics Agency (2016).
https://www.crimestatistics.vic.gov.au/crime‐statistics/latest‐crime‐data/family‐incidents‐0
Department of Health and Human Services Local Government Profile Data (2016).
https://www2.health.vic.gov.au/about/publications/data/barwon‐south‐western‐region‐2015
Mouzos J., Makkai T. (2004). Women’s experiences of male violence: Findings from the Australian
component of the international violence against women survey.
aic.gov.au/media_library/publications/rpp/56/rpp056.pdf
Smith JL., (2005). The impact of intimate partner violence on children. In Intimate partner violence
and health professionals. Edited by Roberts G, Hegarty K, Feder G. London, UK: Elsevier; p127‐144.
Stayton CD., (2005). Mutable influences on Intimate Partner Abuse Screening in Health Care Settings:
a Synthesis of the Literature. Trauma. Violence and Abuse 2005, 6(271):271‐285.
UNICEF (2010). Declaration on the Elimination of Violence against Women, at
222.un.org/womenwatch/daw/cedaw
Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA; International Child
Development Steering Group. Child development: risk factors for adverse outcomes in developing
countries. Lancet. 2007;369(9556):145‐57.
Appendix
LGA PROFILE: CAMPERDOWN, VICTORIA
Corangamite Shire is located in the Barwon South Western region with its most populous
community, Camperdown, about 191 km south‐west of Melbourne.
Population
• Actual annual population change (2004–2014) was below the state measure, and projected annual
population change (2014–2024) is among the lowest in the state.
• The total fertility rate is among the highest in the state.
• People aged 15–44 are under‐represented in the population while all other age groups are
over‐represented.
Diversity
• The percentage of people born in a non‐English speaking country is among the lowest in the state.
• The rate of new settler arrivals per 100,000 population is among the lowest in the state.
• The percentage of people who believe multiculturalism makes life better is among the lowest in
the state.
Disadvantage and social engagement
• The unemployment rate is among the lowest in the state.
• The percentage of sole parent families headed by a male parent is among the highest in the state.
• The percentage of people who are members of a sports group is among the highest in the state.
Housing, transport and education
• The percentage of rental housing that is affordable is above the state measure.
• The percentage of households with rental stress is among the lowest in the state.
• A higher than average percentage of the population did not complete year 12.
Health status and service utilisation
• The percentage of people reporting heart disease is among the highest in the state.
• The percentage of people reporting adequate work‐life balance is among the highest in the state.
• The projected annual change in inpatient separations between 2014/15 and 2026/27 is among the
lowest in the state.
• The rate of potentially avoidable separations for acute conditions is among the highest in the state.
Child and family characteristics and service utilisation
• The percentage of children with speech or language problems at school entry is among the highest
in the state.